FWA Insights: Catching schemes related to Ozempic, Wegovy, and semaglutides
Learn the emerging schemes in the market related to the new drug.
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Cotiviti FWA Insights
In this series, Cotiviti’s eagle-eyed special investigative unit (SIU) breaks down recent fraud, waste, and abuse (FWA) schemes they’ve uncovered to help health plans stay one step ahead of bad actors.
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FWA Insights: Flagging high-frequency telehealth claims
Learn how Cotiviti’s SIU investigated suspicious telehealth claim activity.
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FWA Insights: Prepay review leads to >$100K in projected annual savings
Learn how Cotiviti's SIU identified a suspicious pattern of psychotherapy claims from one provider, preventing inappropriate claims from being paid.
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Catching potential drug testing fraud%%Watch the on-demand webinar
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Claim Pattern Review solution
Prevent FWA before claims are paid and flag providers that warrant immediate investigation
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Fraud, Waste, and Abuse (FWA) Management solution
Detect and deter fraud, waste, and abuse (FWA) while meeting compliance and financial goals
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Dental Claim Accuracy solution
Reduce the costs of inappropriate dental claims
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FWA Insights: Catching improper billing within genetic testing and molecular pathology
Learn different FWA patterns specific to genetic testing services from Cotiviti’s SIU.
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FWA Insights: Managing FWA for dental claims
Learn the latest in dental FWA and explore best practices for prevention.
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FWA Insights: Spotting overpayments in mental health services
Learn how Cotiviti’s SIU uncovered an overpayment of over $2 million related to mental health services.
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FWA Insights: Catching inappropriate billing within ASD services
Learn how Cotiviti's SIU caught a fraudulent pattern within applied behavior analysis.
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FWA Insights: Flagging for excessive modifiers
Learn how Cotiviti helped one plan identify inappropriate modifiers leading to the identification of a >$1 million overpayment.
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FWA Insights: Spotting red flags in adult day care claims
Learn how Cotiviti’s SIU identified an adult day care scheme that led to a $1 million overpayment.
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FWA Insights: Flagging potential physical therapy schemes
Learn how Cotiviti’s SIU flagged an excess of CPT 97799 codes through prepayment review and data analysis.
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FWA Insights: How to catch a DME scheme
Learn how Cotiviti’s eagle-eyed SIU caught a chiropractor billing multiple times for durable medical equipment (DME).
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Rising telehealth: Catching FWA in behavioral health claims
Discover how the pandemic affected behavioral health claims and learn different tactics for avoiding fraud, waste, and abuse.
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